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APPLICATIOrI FOR COMSTRU�T�ON P�RMIT <br /> everett <br /> �e�•Evniprwn . . . .. � <br /> 1:11 Y OF <br /> everett <br /> �UILDING DEPARTMENT <br /> 259-ee�0 TO BE COMPLETED IN INK—PLEASE PRINT <br /> DEMOLITION I I COMBINATION XXBUILDING �i)4MECHANICAL �F�PLUMBING I � SIGN <br /> UWI�ER MAIIADUflE55 CIIV 11P PIIOAE <br /> Salprt- ur�ma5..� 7nn_ 237 F.lm St� vP�st� WA 98203-1921 206 258-1503 <br /> IINANI IMIlAO�flEu5 CITY 21P PIION! <br /> --c�-�rl — <br /> nNLM11EC10fiDE510f1EH 1M0.ADDflESS CIiY ZIP PMONE <br /> o[NEflKLONiflACTOR IMIADDPE55 C�TY Z�P YIqNE lIG6N5E1 <br /> Sa7��r Homeq, rnc 237 Elm St�Everett WA 98203-1921 SELECHI110KN _ <br /> ul Cr1aN�CN CON1fl�ClOfl 1Mk�DDRESS piY ZiP P1qtiE IiCENSk I <br /> ��IUMBINGCON7PAGlOfl MALLMDIiES$ CI1Y ' Z�P PMONE LICENSE� <br /> I;LASS OF NVflll <br /> ��� NEW I�.I ADDITION I I ALTEflATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVBFRPL INSERT l 1 BUILDING HELOCATION <br /> I INANI MIPNOVEMENT OH W7EflIOR flEMODEI ONIY CONIAGT PERSON NID YHONE NO. <br /> cUNIRACIPNKEOFWOHK: r1C1 Clark 258-1503 or 348-1320 <br /> UCSCflIBE WOfllt AND SOWHE FOOIAGE INVOLVEU <br /> �•noaoseouseorew�owc ' " 1 HEREBY CERTIFY THAT I HAVE READ AND LXAMINED TNIS <br /> ���� f�^� • APPLICATION AND KNOW THE SAME TO BE TRUE 4ND CORRECT.ALL <br /> iEGA�DE eis---d PFroNOFenoae Y�SMOWNBEIOWGRATIACHFWflCOPIE:i� PROVISIONSOFLAWSANDORDINANCESGOVERNINGIHISTYPEOF <br /> � . WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �m Z � e�ocn op R;Agawtx�d Te NOL TME GRANTING OF A PERMIT DOES NO7 PRESUME TO GIVE <br /> D1V1S10R 1 . AUTHOHITV TO VIOLATF OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OH THE <br /> . � PERFORMANCE OF CONSTRUCTION.THA7 I AM AUTHORIZED BY THE <br /> �'�7� �f OWNER OF THIS PflOPERTY TO PERFORM THE WORK FOR WHICH <br /> qpPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> � CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> $IC�NTU�iEOFCONTqACTOflOPAU7HOflRED�GENT DATE <br /> ySELECT HOMES, INC. <br /> �aw�ecr nooH/_` ZI ' /� U A BY:� �SLC/�—C/ 3•l3 '9 i <br /> /D�f APPtILANTSqTYBUSInESSL ENSEryO.µDUu5ME5SNNAE <br /> PLUMBING ' ' MECMANICAL <br /> N0. TYPE OF FtXTURE OH ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> 3 WATER CLOSET�TOILET) � A!C—AIHNDLG UNITS—H.P. � <br /> 1 BATNTUB ' 1 FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> 3 LAVATONY(WASH BASIN) � UNIT HEATERS—B.LU. M <br /> z SHOWER � 1 CLOTHES DRYERS <br /> ], KITCMEN SINK 8 DISP i ' 1 VENTILATION FAN <br /> 1 DISHWASHER � 1 RANGE HOOD <br /> LAUNDRYTRAY � �1 WATER HEATER <br /> 1 CLOTHES WASHER � WOOD STOVE <br /> URINAL ' 1 METAL FIREPLACE 8 CHIMNEY <br /> ORINKING FOUNTAIN � � � � FIREPLACE INSERT <br /> FLOOR DRAIN � HEAT PUMP � <br /> 6ACKFLOW PREVENTEFlS ; —Q GAS PIPING ' <br /> ROOF DRAINS—RAINLEADERS � E%HAUST FAN �— <br /> SINK(SERVICE—I1,iR,ETC.) ; ' <br /> � <br /> T <br /> � <br /> 1 <br /> 1 <br /> SU8 TOTAL S ; SUB TOTAL 5 ' <br /> PERMIT f � PERMIT S <br /> TOTALFEE S ' TOTALFEE f <br /> iNONiSEIBACK flEMSEiBACK SIDESET6ICK PlANC11ELKNUMOEN/%/� FE\ � . � HECEIPI � /.J <br /> _�L Z. ..� ' U% N <br /> �si zone / w�e�7n VACNIi SITE FEES VALUATION FEE <br /> i(/ ,� ` � ❑ YES ❑ NO �ILOING � C� � <br /> nrim�coAxs1teuownuu trr[wrncox�si.ecm.0 ��� b��+�ww�� , <br /> J!Iv ._WV 3 M 1 I PLUMBING <br /> .i[I,G OLDG NOAFSTOI11F5 OASEMENT MECHANICAL � <br /> � `� -r _/Yy�. 2- ❑ YES �NO - --� ; <br /> 1GCUYANCYl0�0 FIRESYRNRLERSREO'0 HEIGMT4NITATqN ' �iMER <br /> N � 1� YES 'yd NO SiAlEBU0.UWG5UHGrWIGE <br /> �.Cn50nFOI1SPBINnLkfiS -- - --•-. .. _- 1 .. ... <br /> STAiE ENERGY SUF1Ct1AFiGE , <br /> ;.i�i'L�CAIiONAGCbY wv.s��eoer ��jyrO'F,EcV'E1R[EII puyuCWWb.� Y• ^ <br /> �. .� L01rI�1�II�KS <br /> 4 <'v J�n ux cooE�s�ius �ou� <br />